Abstract
Background. Loss of visual function differs between immune-mediated optic neuropathies and is related to axonal loss in the optic nerve. This study investigated the diagnostic and prognostic value of a biomarker for neurodegeneration, the neurofilament heavy chain (NfH) in three immune-mediated optic neuropathies. Methods. A prospective, longitudinal study including patients with optic neuritis due to multiple sclerosis (MSON, n = 20), chronic relapsing inflammatory optic neuritis (CRION, n = 19), neuromyelitis optica (NMO, n = 9), and healthy controls (n = 28). Serum NfH-SMI35 levels were quantified by ELISA. Findings. Serum NfH-SMI35 levels were highest in patients with NMO (mean 0.79 ± 1.51 ng/mL) compared to patients with CRION (0.13 ± 0.16 ng/mL, P = 0.007), MSON (0.09 ± 0.09, P = 0.008), and healthy controls (0.01 ± 0.02 ng/mL, P = 0.001). High serum NfH-SMI35 levels were related to poor visual outcome. Conclusions. Blood NfH-SMI35 levels are of moderate diagnostic and more important prognostic value in immune-mediated optic neuropathies. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions.
Highlights
An established biomarker for neurodegeneration are body fluid neurofilament (Nf) levels [1,2,3]
Serum NfHSMI35 levels were significantly higher in patients with NMO compared to patients with Chronic Relapsing Inflammatory Optic Neuropathy (CRION) (0.13 ± 0.16 ng/mL, P = 0.007), MSON (0.09 ± 0.09, P = 0.008), and healthy controls (0.01 ± 0.02 ng/mL, P = 0.001, Figure 1)
To the best of our knowledge, this is the first published study reporting the levels of NfHSMI35 in the serum of patients with NMO and CRION
Summary
An established biomarker for neurodegeneration are body fluid neurofilament (Nf) levels [1,2,3]. Cerebrospinal Fluid levels (CSF) of the Nf heavy chain (NfH SMI35) were higher in patients with a Clinically Isolated Syndrome including optic neuritis compared to control subjects and to correlate with disease activity [5] A Japanese study found the CSF NfHSMI35 concentration to be higher in patients with NMO (mean 0.75 ng) compared with the levels found in multiple sclerosis (MS, 0.09 ng/mL) [6]. This data is consistent with a European study [7]. We speculate that longitudinal blood NfH levels may help to identify particular disabling events in relapsing conditions
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